A Novel Approach to Phototherapy Initiation in Preterm Infants

2020 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Shabih Manzar
Keyword(s):  
Body Weight ◽  
Birth Weight ◽  
Preterm Infants ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Therapeutic Interventions ◽  
Novel Approach

Therapeutic interventions in preterm infants are determined based on birth weight. Phototherapy (PTx) is the treatment for hyperbilirubinemia, started based on serum bilirubin level. However, weight-based guidelines for PTx in preterm infants are lacking. We present a simple way of calculating the bilirubin to initiate PTx. A percentage body weight, ranging from 0.5%-1%, is used to calculate bilirubin.

Relationship of Serum Bilirubin Levels to Ototoxicity and Deafness in High-Risk Low-Birth-Weight Infants

PEDIATRICS ◽  
1985 ◽  
Vol 76 (3) ◽  
pp. 351-354
Author(s):  
L. S. de Vries ◽  
S. Lary ◽  
L. M.S. Dubowitz
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Preterm Infants ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Sensorineural Deafness ◽  
Serum Bilirubin Level ◽  
Low Birth Weight Infants ◽  
High Risk Infants ◽  
L 14

During a 4-year period, 12 premature infants, all less than 34 weeks of gestation and all with a bilirubin level above 240 µmol/L (14 mg/dL) were determined to have bilateral sensorineural deafness. In order to investigate how far the hyperbilirubinemia or any associated factor might have been a causative factor, all infants of 34 weeks of gestation or less who had a serum bilirubin level above 240 µmol/L were investigated. For a period of 4 years, 99 infants meeting these criteria were classified as high risk or low risk on the basis of perinatal risk factors. Eight of the 22 high-risk infants with birth weight less than 1,500 g, but only two of 43 high-risk infants with birth weight greater than 1,500 g were deaf (P < .05). The deaf infants were also matched with infants of normal hearing who had similar bilirubin levels and the same number of adverse perinatal factors. The mean duration of hyperbilirubinemia was significantly longer in the deaf infants (P < .02), and they appeared to have a greater number of acidotic episodes while they were hyperbilirubinemic. These findings suggest that in healthy preterm infants with birth weight greater than 1,500 g, high bilirubin levels carry little risk, whereas a serum bilirubin level greater than 240 µmol/L in highrisk preterm infants with birth weight of 1,500 g or less is associated with a high risk of deafness.

Double Versus Single Phototherapy in Low Birth Weight Newborns

PEDIATRICS ◽  
1992 ◽  
Vol 90 (5) ◽  
pp. 674-677
Author(s):  
Paul C. Holtrop ◽  
Kathleen Ruedisueli ◽  
M. Jeffrey Maisels
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Elevated Serum ◽  
Threshold Level ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
The Difference ◽  
To Receive

Conventional phototherapy systems that simultaneously irradiate the front and the back of the baby lower the serum bilirubin level more rapidly than one-sided systems, but they are impractical. Fiberoptic phototherapy makes it easy to administer conventional phototherapy from above while the infant lies on a fiberoptic phototherapy blanket. Newborns with birth weights less than 2500 g were randomly assigned to receive either single (n = 37) or double (n = 33) phototherapy. The groups were similar in clinical and laboratory characteristics. After 18 hours of therapy the serum bilirubin concentration declined by 31 ± 11% in the double and 16 ± 15% in the single phototherapy group (2.9 ± 1.1 vs 1.6 ± 1.4 mg/dL), and the difference in the total serum bilirubin levels after 18 hours of therapy was significant (double phototherapy group 7.1 ± 2.7 mg/dL vs single phototherapy group 8.2 ± 2.6 mg/dL). After 18 hours of treatment the serum bilirubin level was less than the phototherapy threshold level in 26 of 37 single phototherapy patients vs 32 of 33 double phototherapy patients. Double phototherapy was well tolerated. It is concluded that this type of double phototherapy is more effective than single phototherapy in low birth weight newborns. Double phototherapy may be useful when it is necessary to reduce an elevated serum bilirubin level as rapidly as possible or when the bilirubin level is rising with single phototherapy.

scholarly journals Phototherapy in different stages of birth weight for the treatment of neonatal hyperbilirubinaemia

1970 ◽  
Vol 18 ◽  
pp. 116-120
Author(s):  
T Paul ◽  
R Parial ◽  
MA Hasem ◽  
S Mojumder ◽  
MM Islam ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Bilirubin Level ◽  
Neonatal Sepsis ◽  
Serum Bilirubin ◽  
Very Low Birth Weight ◽  
Perinatal Asphyxia ◽  
Serum Bilirubin Level ◽  
Decline Rate ◽  
Group 1

Context: The goal of phototherapy is to lower the concentration of circulating bilirubin or keep it from increasing in the treatment of neonatal unconjugated hyperbilirubinaemia. As phototherapy decrease billirubin level of infants, it is important to fix the dose of phototherapy.   Objectives: The aim of the study was to compare the effectiveness of double phototherapy versus conventional single phototherapy in the treatment of neonatal unconjugated hyperbilirubinaemia.   Materials and Methods: For this purpose 50 term and preterm newborns were enrolled. They were divided into 2 groups, 38 newborns were taken in group 1 and 12 newborn were taken in group 2. The babies who got conventional single phototherapy were taken in group 1. Each group was again divided into 3 subgroups according to their birth weight Normal Birth Weight (NBW), = Low Birth Weight (LBW) and Very Low Birth Weight (VLBW).   Results: The serum bilirubin level of term babies were found 17.32 ± 4.08 mg/dl and in preterm babies were found 13.17 ± 1.49 mg/dl. Neonatal hyperbilirubinaemia in enrolled babies were due to physiologic jaundice (38%), neonatal sepsis (50%) and perinatal asphyxia (12%). The serum bilirubin level in physiological jaundice was found 18.47 ± 5.38 mg/dl, in neonatal sepsis was found 14.90 ± 1.85 mg/dl and in perenatal asphyxia was found 14.10 ± 1.47 mg / dl. Decline rate of serum bilirubin per day was found 4.58 ± 2.43 mg / dl in NBW babies with the use of conventional single phototherapy compared to 6.27 ± 2.26 mg / dl with the use of conventional double phototherapy. In LBW babies decline rate of serum bilirubin per day was found 2.07 ± 0.84 mg / dl with the use of conventional single phototherapy but 4.70 ± 2.08 mg / dl with the use of conventional double phototherapy. In VLBW babies, decline rate of serum bilirubin per day was found 2.24 ± 1.10 mg / dl with the use of conventional single phototherapy. Any VLBW babies which were given conventional double phototherapy were not found. Conclusion: From this study it can be concluded that double phototherapy is more effective than conventional single phototherapy in the treatment of neonatal hyperbilirubinaemia in both groups of neonates; however the rate of fall of bilirubin was higher in NBW subgroups. Keywords: Phototherapy; hyperbilirubinaemia; preterm; term. DOI: http://dx.doi.org/10.3329/jbs.v18i0.8786 JBS 2010; 18(0): 116-120

scholarly journals Hyperbilirubinemia in Preterm Infants Admitted to Neonatal Intensive Care Units in Ethiopia

2020 ◽  
Vol 7 ◽  
pp. 2333794X2098580
Author(s):  
Sara Aynalem ◽  
Mahlet Abayneh ◽  
Gesit Metaferia ◽  
Abayneh G. Demissie ◽  
Netsanet Workneh Gidi ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Preterm Infants ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
P Value ◽  
Abo Incompatibility ◽  
Preterm Babies

Background. Hyperbilirubinemia is prevalent and protracted in preterm infants. This study assessed the pattern of hyperbilirubinemia in preterm infants in Ethiopia. Methods. This study was part of multi-centered prospective, cross-sectional, observational study that determined causes of death among preterm infants. Jaundice was first identified based on clinical visual assessment. Venous blood was then sent for total and direct serum bilirubin level measurements. For this study, a total serum bilirubin level ≥5 mg/dL was taken as the cutoff point to diagnose hyperbilirubinemia. Based on the bilirubin level and clinical findings, the final diagnoses of hyperbilirubinemia and associated complications were made by the physician. Result. A total of 4919 preterm infants were enrolled into the overall study, and 3852 were admitted to one of the study’s newborn intensive care units. Of these, 1779 (46.2%) infants were diagnosed with hyperbilirubinemia. Ten of these (0.6%) developed acute bilirubin encephalopathy. The prevalence of hyperbilirubinemia was 66.7% among the infants who were less than 28 weeks of gestation who survived. Rh incompatibility ( P = .002), ABO incompatibility ( P = .0001), and sepsis ( P = .0001) were significantly associated with hyperbilirubinemia. Perinatal asphyxia ( P-value = 0.0001) was negatively associated with hyperbilirubinemia. Conclusion. The prevalence of hyperbilirubinemia in preterm babies admitted to neonatal care units in Ethiopia was high. The major risk factors associated with hyperbilirubinemia in preterm babies in this study were found to be ABO incompatibility, sepsis, and Rh isoimmunization.

Effect of Addition of Probiotics to Standard Treatment on Neonatal Jaundice

2021 ◽  
Vol 17 (2) ◽  
pp. 199-203
Author(s):  
Tehreem Afzal ◽  
Naveed Butt ◽  
Shahzad Munir ◽  
Nazish Zia
Keyword(s):  
Bilirubin Level ◽  
Neonatal Jaundice ◽  
Standard Treatment ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Combination Group ◽  
Medical Institute ◽  
Significant Difference ◽  
The Mean ◽  
Time Required

Objective: To compare the mean change in the bilirubin levels with addition of probiotics to standard treatment for the management of neonatal jaundice. Methodology: The randomized controlled trial was undertaken at the Neonatal Intensive Care Unit of the Paediatrics Department, Federal Government Polyclinic (Post Graduate Medical Institute), Islamabad from 1st April to 30th September 2019.  Neonates with hyperbilirubinemia requiring phototherapy were randomly divided into two groups, each having 30 patients. Group A received probiotics along with phototherapy while group B received phototherapy alone. Primary outcome was serum total bilirubin, which was calculated on 0, 1 and 3 days of treatment. Duration of phototherapy and patient's outcome was also recorded. Data was analyzed statistically using SPSS v. 23. Results: The mean serum bilirubin level after 24 hours was 14.27 ± 4.35 mg/dl in combination group while 16.43 ± 4.36 mg/dl in phototherapy group (p > 0.05). After 48 hours, the mean serum bilirubin level was 12.37 ± 3.33 mg/dl in combination group while 14.09 ± 3.60 mg/dl in phototherapy group (p > 0.05). After 72 hours, the mean serum bilirubin level was 11.09 ± 2.87 mg/dl in combination group while 11.72 ± 2.96 mg/dl in phototherapy group (p > 0.05). The mean time required of blue light phototherapy was 43.47 ± 20.71 hours in combination group while 61.53 ±28.27 hours in phototherapy group (p < 0.05). All neonates were discharged. Conclusion: Addition of probiotics to standard treatment decreased the time required for the phototherapy in neonatal jaundice. However no statistically significant difference was seen in the bilirubin levels between the two groups.

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